BILL ANALYSIS                                                                                                                                                                                                    




                    Appropriations Committee Fiscal Summary
          
                                           921 (Kuehl)
          
          Hearing Date:  5/29/03          Amended: 5/14/03       
          Consultant:  George Cate            Policy Vote: INS 5-3  
          H&HS 8-3                 
          ____________________________________________________________ 
          ___
          BILL SUMMARY: 
          SB 921 establishes the California Health Care System (CHCS)  
          to provide universal health care to all Californians  
          through a single payer delivery system administered by the  
          newly created California Health Care Agency.  This bill  
          also creates a statewide elected Health Care Commissioner  
          to administer the Agency, which would be comprised of a  
          Health Policy Board, Office of Consumer Advocacy and Office  
          of Medical Practice Standards.  The bill further stipulates  
          that CHCS shall provide universal and affordable health  
          care coverage, including prescription drugs, to all  
          residents, and control the growth of health care costs.

          In addition, this measure authorizes the redirection of  
          existing funding for current government health programs and  
          requires the Commissioner to seek all necessary waivers or  
          legislation to allow various health care payments to be  
          paid to CHCS, which would then assume the responsibility  
          for all benefits and services previously paid for with  
          those funds.

                              Fiscal Impact (in thousands)
           
          Major Provisions        2003-04            2004-05               2005-06   
           Fund  
          
          Benefits          Unknown                    Various
          Administration    Unknown                    Various

          
          STAFF COMMENTS:  SUSPENSE FILE
          It has been estimated by several sources that it would cost  
          tens of billions of dollars to provide health care coverage  
          to the six million or more uninsured in this state.  There  
          would also be billions of dollars in start-up and  
          administration costs related to the new agency.   
          Furthermore, there would be billions of dollars in savings  










          that would result from eliminating our current delivery  
          system and replacing it with a single payer system.

          STAFF NOTES that the latest amendments to this bill  
          eliminated references to the Legislature's intent to  
          dedicate various sources of new revenue to fund CHCS.   
          These included an employee health care tax, personal income  
          surtax, cigarette and tobacco surtax, and alcohol surtax to  
          fund the remaining costs.  At present there are no funding  
          mechanisms in the bill for the additional costs associated  
          with CHCS.

          PROPOSED AMENDMENTS would reduce this bill to legislative  
          intent to implement a single payer universal health care  
          delivery system in California.